Provider Demographics
NPI:1558479857
Name:CORTEZ, OLGA LETICIA (MD)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:LETICIA
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 STEVE SMITH WAY
Mailing Address - Street 2:
Mailing Address - City:CROSS ROADS
Mailing Address - State:TX
Mailing Address - Zip Code:76227-3668
Mailing Address - Country:US
Mailing Address - Phone:940-365-3030
Mailing Address - Fax:940-365-3032
Practice Address - Street 1:3800 STEVE SMITH WAY
Practice Address - Street 2:
Practice Address - City:CROSS ROADS
Practice Address - State:TX
Practice Address - Zip Code:76227-3668
Practice Address - Country:US
Practice Address - Phone:940-365-3030
Practice Address - Fax:940-365-3032
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2590207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183884901Medicaid
TX8G8105Medicare ID - Type Unspecified
TX183884901Medicaid